[ { "key": "RVM84BZP", "version": 1580, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/RVM84BZP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/RVM84BZP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Reisenauer", "numChildren": 0 }, "data": { "key": "RVM84BZP", "version": 1580, "itemType": "journalArticle", "title": "PerOral Plication of the Esophagus (POPE): A Novel Approach to Megaesophagus", "creators": [ { "creatorType": "author", "firstName": "Janani", "lastName": "Reisenauer" } ], "abstractNote": "", "publicationTitle": "", "publisher": "", "place": "", "date": "", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.25373/ctsnet.6270281", "citationKey": "", "url": "www.ctsnet.org/article/peroral-plication-esophagus-pope-novel-approach-megaesophagus", "accessDate": "2019-11-15T14:30:26Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "PerOral Plication of the Esophagus (POPE)", "language": "en", "libraryCatalog": "www.ctsnet.org", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "8QIVK528" ], "relations": {}, "dateAdded": "2019-11-15T14:30:26Z", "dateModified": "2019-11-15T16:02:43Z" } }, { "key": "SXLQ5Y4P", "version": 1575, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/SXLQ5Y4P", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/SXLQ5Y4P", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Yano et al.", "parsedDate": "2017", "numChildren": 0 }, "data": { "key": "SXLQ5Y4P", "version": 1575, "itemType": "journalArticle", "title": "Learning curve for laparoscopic Heller myotomy and Dor fundoplication for achalasia", "creators": [ { "creatorType": "author", "firstName": "Fumiaki", "lastName": "Yano" }, { "creatorType": "author", "firstName": "Nobuo", "lastName": "Omura" }, { "creatorType": "author", "firstName": "Kazuto", "lastName": "Tsuboi" }, { "creatorType": "author", "firstName": "Masato", "lastName": "Hoshino" }, { "creatorType": "author", "firstName": "Seryung", "lastName": "Yamamoto" }, { "creatorType": "author", "firstName": "Shunsuke", "lastName": "Akimoto" }, { "creatorType": "author", "firstName": "Takahiro", "lastName": "Masuda" }, { "creatorType": "author", "firstName": "Hideyuki", "lastName": "Kashiwagi" }, { "creatorType": "author", "firstName": "Katsuhiko", "lastName": "Yanaga" } ], "abstractNote": "PURPOSE: Although laparoscopic Heller myotomy and Dor fundoplication (LHD) is widely performed to address achalasia, little is known about the learning curve for this technique. We assessed the learning curve for performing LHD.\nMETHODS: Of the 514 cases with LHD performed between August 1994 and March 2016, the surgical outcomes of 463 cases were evaluated after excluding 50 cases with reduced port surgery and one case with the simultaneous performance of laparoscopic distal partial gastrectomy. A receiver operating characteristic (ROC) curve analysis was used to identify the cut-off value for the number of surgical experiences necessary to become proficient with LHD, which was defined as the completion of the learning curve.\nRESULTS: We defined the completion of the learning curve when the following 3 conditions were satisfied. 1) The operation time was less than 165 minutes. 2) There was no blood loss. 3) There was no intraoperative complication. In order to establish the appropriate number of surgical experiences required to complete the learning curve, the cut-off value was evaluated by using a ROC curve (AUC 0.717, p < 0.001). Finally, we identified the cut-off value as 16 surgical cases (sensitivity 0.706, specificity 0.646).\nCONCLUSION: Learning curve seems to complete after performing 16 cases.", "publicationTitle": "PloS One", "publisher": "", "place": "", "date": "2017", "volume": "12", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "e0180515", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "PLoS ONE", "DOI": "10.1371/journal.pone.0180515", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1932-6203", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 28686640\nPMCID: PMC5501549", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Esophageal Achalasia", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Fundoplication", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intraoperative Complications", "type": 1 }, { "tag": "Laparoscopy", "type": 1 }, { "tag": "Laparotomy", "type": 1 }, { "tag": "Learning Curve", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Muscles", "type": 1 }, { "tag": "Operative Time", "type": 1 }, { "tag": "ROC Curve", "type": 1 }, { "tag": "Tendons", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "H4KSJU5H" ], "relations": {}, "dateAdded": "2017-12-06T22:15:24Z", "dateModified": "2017-12-06T22:15:24Z" } }, { "key": "B4HPA3SZ", "version": 1574, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/B4HPA3SZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/B4HPA3SZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Kiudelis et al.", "parsedDate": "2017-09", "numChildren": 0 }, "data": { "key": "B4HPA3SZ", "version": 1574, "itemType": "journalArticle", "title": "The choice of optimal antireflux procedure after laparoscopic cardiomyotomy: two decades of clinical experience in one center", "creators": [ { "creatorType": "author", "firstName": "Mindaugas", "lastName": "Kiudelis" }, { "creatorType": "author", "firstName": "Egle", "lastName": "Kubiliute" }, { "creatorType": "author", "firstName": "Egidijus", "lastName": "Sakalys" }, { "creatorType": "author", "firstName": "Laimas", "lastName": "Jonaitis" }, { "creatorType": "author", "firstName": "Antanas", "lastName": "Mickevicius" }, { "creatorType": "author", "firstName": "Zilvinas", "lastName": "Endzinas" } ], "abstractNote": "INTRODUCTION: Two types of partial wrap are commonly performed in achalasia patients after Heller myotomy: the posterior 270° fundoplication (Toupet) and the anterior 180° fundoplication (Dor). The optimal type of fundoplication (posterior vs. anterior) is still debated.\nAIM: To compare the long-term rates of dysphagia, reflux symptoms and patient satisfaction with current postoperative condition between two fundoplication groups in achalasia treatment.\nMATERIAL AND METHODS: Our retrospective study included 97 consecutive patients with achalasia: 37 patients underwent laparoscopic posterior Toupet (270°) fundoplication followed by Heller myotomy (group I); 60 patients underwent laparoscopic anterior partial Dor fundoplication followed by Heller myotomy (group II). Long-term follow-up results included evaluation of dysphagia symptoms, intensity of heartburn and patient satisfaction with current condition.\nRESULTS: Patients in these two groups did not differ according to age, weight, height, postoperative stay or follow-up period. Laparoscopic myotomy with posterior Toupet fundoplication was effective in 89% of patients, while laparoscopic myotomy with anterior Dor was effective in 93% of patients (p > 0.05). 11% of patients after posterior Toupet fundoplication had clinically significant heartburn vs. 35% of patients after anterior Dor fundoplication (p < 0.05). Overall patient satisfaction with current condition was 88%, with no significant difference between the groups.\nCONCLUSIONS: According to our study results, the two laparoscopic techniques were similarly effective in reducing achalasia symptoms, but postoperative clinical manifestation of heartburn is significantly more frequent after anterior Dor fundoplication (35% vs. 11%). The majority of patients (88%) were satisfied with operation outcomes.", "publicationTitle": "Wideochirurgia I Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques", "publisher": "", "place": "", "date": "Sep 2017", "volume": "12", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "238-244", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Wideochir Inne Tech Maloinwazyjne", "DOI": "10.5114/wiitm.2017.68547", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1895-4588", "archive": "", "archiveLocation": "", "shortTitle": "The choice of optimal antireflux procedure after laparoscopic cardiomyotomy", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 29062443\nPMCID: PMC5649496", "tags": [ { "tag": "achalasia", "type": 1 }, { "tag": "fundoplication", "type": 1 }, { "tag": "laparoscopic Heller myotomy", "type": 1 } ], "collections": [ "28DZFPBE" ], "relations": {}, "dateAdded": "2017-12-06T20:19:57Z", "dateModified": "2017-12-06T20:19:57Z" } }, { "key": "H3VE5PEZ", "version": 1573, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/H3VE5PEZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/H3VE5PEZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Repici et al.", "parsedDate": "2017-11-01", "numChildren": 0 }, "data": { "key": "H3VE5PEZ", "version": 1573, "itemType": "journalArticle", "title": "Gastroesophageal reflux disease after per-oral endoscopic myotomy as compared with Heller's myotomy with fundoplication: a systematic review with meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Alessandro", "lastName": "Repici" }, { "creatorType": "author", "firstName": "Lorenzo", "lastName": "Fuccio" }, { "creatorType": "author", "firstName": "Roberta", "lastName": "Maselli" }, { "creatorType": "author", "firstName": "Fabrizio", "lastName": "Mazza" }, { "creatorType": "author", "firstName": "Loredana", "lastName": "Correale" }, { "creatorType": "author", "firstName": "Daniele", "lastName": "Mandolesi" }, { "creatorType": "author", "firstName": "Cristina", "lastName": "Bellisario" }, { "creatorType": "author", "firstName": "Amrita", "lastName": "Sethi" }, { "creatorType": "author", "firstName": "Mouen", "lastName": "Kashab" }, { "creatorType": "author", "firstName": "Thomas", "lastName": "Rösch" }, { "creatorType": "author", "firstName": "Cesare", "lastName": "Hassan" } ], "abstractNote": "BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) represents a less invasive alternative, as compared with conventional laparoscopic Heller's myotomy (LHM), for achalasia patients. It cannot be excluded, however, that the lack of fundoplication after POEM may result in a higher incidence of reflux disease, as compared with LHM. The aim was to conduct a systematic review of prospective studies reporting the incidence of reflux disease developed after POEM and LHM.\nMETHODS: Literature search with electronic databases was performed (up to February 2017) to identify full articles on the incidence of gastro-esophageal reflux symptoms, endoscopic- and pH-monitoring-findings after POEM and LHM (with fundoplication). Proportions and rates were pooled by means of a random or fixed effects models, according to the level of heterogeneity between studies.\nRESULTS: After applying the selection criteria, 17 and 28 studies, including 1,542 and 2,581 subjects who underwent POEM and LHM, respectively, were included. Pooled rate of postprocedure symptoms was 19.0% (95% CI, 15.7%-22.8%) after POEM, and 8.8% (95% CI, 5.3%-14.1%) after LHM, respectively. Pooled rate estimate of abnormal acid exposure at pH-monitoring was 39.0% (95% CI, 24.5%-55.8%) after POEM, and 16.8% (95% CI, 10.2%-26.4%) after LHM, respectively. Rate of post-POEM esophagitis was 29.4% (95% CI, 18.5%-43.3%) after POEM, and 7.6% (95% CI, 4.1%-13.7%) after LHM. At meta-regression, heterogeneity was partly explained by POEM approach and study population.\nCONCLUSIONS: Incidence of reflux-disease appears to be significantly more frequent after POEM than after LHM with fundoplication. pH-monitoring and appropriate treatment after POEM should be considered in order to prevent long-term reflux-related adverse events.", "publicationTitle": "Gastrointestinal Endoscopy", "publisher": "", "place": "", "date": "Nov 01, 2017", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Gastrointest. Endosc.", "DOI": "10.1016/j.gie.2017.10.022", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1097-6779", "archive": "", "archiveLocation": "", "shortTitle": "Gastroesophageal reflux disease after per-oral endoscopic myotomy as compared with Heller's myotomy with fundoplication", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 29102729", "tags": [ { "tag": "Achalasia", "type": 1 }, { "tag": "Heller’s Myotomy", "type": 1 }, { "tag": "Interventional Endoscopy", "type": 1 }, { "tag": "Per-Oral Endoscopy Myotomy", "type": 1 } ], "collections": [ "H4KSJU5H" ], "relations": {}, "dateAdded": "2017-12-06T20:12:47Z", "dateModified": "2017-12-06T20:12:47Z" } }, { "key": "J85SB3XC", "version": 1572, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/J85SB3XC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/J85SB3XC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Zhang et al.", "parsedDate": "2017-11-06", "numChildren": 0 }, "data": { "key": "J85SB3XC", "version": 1572, "itemType": "journalArticle", "title": "Per-oral endoscopic myotomy in patients with or without prior Heller myotomy: comparing long-term outcomes in a large U.S. single-center cohort (with videos)", "creators": [ { "creatorType": "author", "firstName": "Xiaocen", "lastName": "Zhang" }, { "creatorType": "author", "firstName": "Rani J.", "lastName": "Modayil" }, { "creatorType": "author", "firstName": "David", "lastName": "Friedel" }, { "creatorType": "author", "firstName": "Krishna C.", "lastName": "Gurram" }, { "creatorType": "author", "firstName": "Collin E.", "lastName": "Brathwaite" }, { "creatorType": "author", "firstName": "Sharon I.", "lastName": "Taylor" }, { "creatorType": "author", "firstName": "Maria M.", "lastName": "Kollarus" }, { "creatorType": "author", "firstName": "Sony", "lastName": "Modayil" }, { "creatorType": "author", "firstName": "Bhawna", "lastName": "Halwan" }, { "creatorType": "author", "firstName": "James H.", "lastName": "Grendell" }, { "creatorType": "author", "firstName": "Stavros N.", "lastName": "Stavropoulos" } ], "abstractNote": "BACKGROUND AND AIMS: Heller myotomy (HM) is one of the most effective treatments for esophageal achalasia. However, failures do exist and the success rate tends to decrease with time. The efficacy of rescue treatments for patients with failed Heller is limited. A few small-scale studies have reported outcomes of per-oral endoscopic myotomy (POEM) in these patients. We conducted this study to systematically assess feasibility, safety, and efficacy of POEM on post-Heller patients.\nMETHODS: Patients at least 3 months out from their POEM were selected from our prospective database: 318 consecutive POEMs performed from October 2009 to October 2016. The efficacy and safety of POEM were compared between the 46 patients with prior HM and the remaining 272 patients.\nRESULTS: Patients with prior Heller myotomy had longer disease history, more advanced disease, more type I and less type II achalasia, lower pre-POEM Eckardt score and lower pre-POEM LES pressure (all p<0.01). Procedure parameters and follow-up results (clinical success rate, Eckardt score, LES pressure, GERD score, esophagitis and pH testing) showed no significant difference between the 2 groups. For the 46 HM-POEM patients, no clinical significant perioperative adverse event occurred. Their overall clinical success (Eckardt score≤3 and no other treatment needed) rate was 95.7% at a median follow-up of 28 months.\nCONCLUSIONS: POEM as a rescue treatment for achalasia patients who failed Heller myotomy is feasible, safe, and highly effective. It should be the treatment of choice in managing these challenging cases at centers with a high level of experience with POEM.", "publicationTitle": "Gastrointestinal Endoscopy", "publisher": "", "place": "", "date": "Nov 06, 2017", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Gastrointest. Endosc.", "DOI": "10.1016/j.gie.2017.10.039", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1097-6779", "archive": "", "archiveLocation": "", "shortTitle": "Per-oral endoscopic myotomy in patients with or without prior Heller myotomy", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 29122601", "tags": [ { "tag": "Heller myotomy", "type": 1 }, { "tag": "esophageal achalasia", "type": 1 }, { "tag": "esophageal motility disorder", "type": 1 }, { "tag": "natural orifice transluminal surgery", "type": 1 }, { "tag": "peroral endoscopic myotomy", "type": 1 } ], "collections": [ "H4KSJU5H" ], "relations": {}, "dateAdded": "2017-12-06T20:08:38Z", "dateModified": "2017-12-06T20:08:38Z" } }, { "key": "L3YFNGBQ", "version": 1571, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/L3YFNGBQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/L3YFNGBQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Müller et al.", "parsedDate": "2017-11-15", "numChildren": 0 }, "data": { "key": "L3YFNGBQ", "version": 1571, "itemType": "journalArticle", "title": "Outcomes of pneumatic dilation in achalasia: extended follow-up of more than 25 years with a focus on manometric subtypes", "creators": [ { "creatorType": "author", "firstName": "Michaela", "lastName": "Müller" }, { "creatorType": "author", "firstName": "Christina", "lastName": "Keck" }, { "creatorType": "author", "firstName": "Alexander J.", "lastName": "Eckardt" }, { "creatorType": "author", "firstName": "Sarah", "lastName": "Werling" }, { "creatorType": "author", "firstName": "Till", "lastName": "Wehrmann" }, { "creatorType": "author", "firstName": "Jochem", "lastName": "König" }, { "creatorType": "author", "firstName": "Ines", "lastName": "Gockel" } ], "abstractNote": "BACKGROUND AND AIMS: Pneumatic dilation (PD) is the most popular non-surgical treatment for achalasia. This study investigated predicting factors, including manometric subtypes for symptom recurrence in the long-term, in patients with achalasia treated with a single PD.\nPATIENTS AND METHODS: Between 1983 and 2013, a total of 107 patients were treated initially with a single PD and included in this longitudinal cohort study. Outcomes were correlated with demographics, symptoms (Eckardt Score), esophagographic and manometric features. Manometric tracings were retrospectively classified according to the 3 subtypes of the Chicago classification.\nRESULTS: Ninety-one (85%) patients were successfully treated after the first PD. The median follow-up was 13.8 years (IQR7-20). During follow-up, 54% of the patients experienced a clinical relapse. The overall cumulative success rates at 2, 5, 10, 15, 20 and 25 years were 64%, 53%, 49%, 42%, 36% and 36%, respectively. Age < 40 years, lower esophageal sphincter (LES) pressure > 15 mmHg, a cardia width < 5mm, and an esophageal barium column height > 1cm 4 to 12 weeks post-dilation significantly correlated with symptom recurrence. Whereas, achalasia subtypes did not significantly correlate with the treatment results.\nCONCLUSION: Pneumatic dilation in achalasia is an effective therapy in the short term, but its effect wanes in the very long-term. Young age at presentation, a high LES pressure, a narrow cardia and an esophageal barium column of > 1cm after PD are predictive factors for the need of repeated treatment.", "publicationTitle": "Journal of Gastroenterology and Hepatology", "publisher": "", "place": "", "date": "Nov 15, 2017", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J. Gastroenterol. Hepatol.", "DOI": "10.1111/jgh.14044", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1440-1746", "archive": "", "archiveLocation": "", "shortTitle": "Outcomes of pneumatic dilation in achalasia", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 29140553", "tags": [ { "tag": "Achalasia", "type": 1 }, { "tag": "long-term remission", "type": 1 }, { "tag": "pneumatic dilation", "type": 1 }, { "tag": "predictors of recurrence", "type": 1 } ], "collections": [ "P8Z4N4V9" ], "relations": {}, "dateAdded": "2017-12-06T20:05:23Z", "dateModified": "2017-12-06T20:05:23Z" } }, { "key": "IRIEFXR3", "version": 1570, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/IRIEFXR3", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/IRIEFXR3", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Nabi et al.", "parsedDate": "2017-11-23", "numChildren": 0 }, "data": { "key": "IRIEFXR3", "version": 1570, "itemType": "journalArticle", "title": "Peroral endoscopic myotomy in treatment-naïve achalasia patients versus prior treatment failure cases", "creators": [ { "creatorType": "author", "firstName": "Zaheer", "lastName": "Nabi" }, { "creatorType": "author", "firstName": "Mohan", "lastName": "Ramchandani" }, { "creatorType": "author", "firstName": "Radhika", "lastName": "Chavan" }, { "creatorType": "author", "firstName": "Manu", "lastName": "Tandan" }, { "creatorType": "author", "firstName": "Rakesh", "lastName": "Kalapala" }, { "creatorType": "author", "firstName": "Santosh", "lastName": "Darisetty" }, { "creatorType": "author", "firstName": "Sundeep", "lastName": "Lakhtakia" }, { "creatorType": "author", "firstName": "G. Venkat", "lastName": "Rao" }, { "creatorType": "author", "firstName": "D. Nageshwar", "lastName": "Reddy" } ], "abstractNote": "Background and study aim Peroral endoscopic myotomy (POEM) has emerged as an effective treatment modality for achalasia. Prior treatment may affect the outcomes of subsequent management. In this study, we aimed to compare the safety and efficacy of POEM in treatment-naïve patients vs. those with prior treatment failure (PTF). Patients and methods The data of consecutive patients with achalasia who underwent POEM at a single tertiary care center from January 2013 to November 2016 were analyzed retrospectively. A comparative analysis was performed between treatment-naïve and PTF cases. Technical and clinical success, adverse events, and operative time for POEM were compared between the two groups. Results Overall, 502 patients with achalasia underwent POEM during the study period: 260 patients (51.8 %) in the treatment-naïve group and 242 patients (48.2 %) in the PTF group. The mean operative time was significantly longer in the PTF group compared with the treatment-naïve group (74.9 ± 30.6 vs. 67.0 ± 27.1 minutes; P  = 0.002). On multivariate analysis, type of achalasia, dilated esophagus ( > 6 cm), disease duration, prior treatment, occurrence of adverse events, and type of knife used were significant predictors of operative time. Technical success (98.1 % vs. 97.1 %; P =  0.56) and clinical success (92.4 % vs. 92.5 %; P  = 0.95) were comparable in the treatment-naïve and PTF cases, respectively. Occurrence of gas-related events and mucosotomy were similar in both groups. Elevated DeMeester score was found in 17 /53 patients (32.1 %) in the PTF group and in 11 /44 patients (25.0 %) in the treatment-naïve group (P = 0.50). Conclusion POEM is safe and equally effective for treatment-naïve patients and for those in whom prior treatment has failed. POEM should be considered the treatment of choice in patients in whom prior treatment has failed.", "publicationTitle": "Endoscopy", "publisher": "", "place": "", "date": "Nov 23, 2017", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Endoscopy", "DOI": "10.1055/s-0043-121632", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1438-8812", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 29169196", "tags": [], "collections": [ "H4KSJU5H" ], "relations": {}, "dateAdded": "2017-12-06T19:50:28Z", "dateModified": "2017-12-06T19:50:28Z" } }, { "key": "9JEXK7QQ", "version": 1569, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/9JEXK7QQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/9JEXK7QQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Wu et al.", "parsedDate": "2017-12-05", "numChildren": 0 }, "data": { "key": "9JEXK7QQ", "version": 1569, "itemType": "journalArticle", "title": "Novel Intra-Procedural Distensibility Measurement Accurately Predicts Immediate Outcome of Pneumatic Dilatation for Idiopathic Achalasia", "creators": [ { "creatorType": "author", "firstName": "P. I.", "lastName": "Wu" }, { "creatorType": "author", "firstName": "M. M.", "lastName": "Szczesniak" }, { "creatorType": "author", "firstName": "P. I.", "lastName": "Craig" }, { "creatorType": "author", "firstName": "L.", "lastName": "Choo" }, { "creatorType": "author", "firstName": "J.", "lastName": "Engelman" }, { "creatorType": "author", "firstName": "B.", "lastName": "Terkasher" }, { "creatorType": "author", "firstName": "J.", "lastName": "Hui" }, { "creatorType": "author", "firstName": "I. J.", "lastName": "Cook" } ], "abstractNote": "OBJECTIVES: Often 2-3 graduated pneumatic dilatations (PD) are required to treat achalasia as there is no current intra-procedural predictor of clinical response. Distensibility measurements using functional lumen imaging probe (FLIP) may provide an intra-procedural predictor of outcome. Our aim was to determine the optimal criterion for esophagogastric junction (EGJ) distensibility measurements during PD that predicts immediate clinical response.\nMETHODS: EGJ distensibility was prospectively measured using FLIP immediately pre- and post-PD. The EGJ distensibility index (EGJ-DI) was defined as a ratio of the narrowest cross-sectional area and the corresponding intra-bag pressure at 40 ml distension. Immediate and short-term clinical responses were defined as Eckardt score ≤3 assessed 2 weeks Post-PD and at 3-month follow-up, respectively.\nRESULTS: In 54 patients, we performed thirty-seven 30 mm; twenty 35 mm and six 40 mm PDs. The short-term response rate to the graded PD was 93% (27/29) in newly diagnosed achalasia; 87% (13/15) and 70% (7/10) in those who had relapsed after previous PD and Heller's Myotomy, respectively. Among those demonstrating an immediate response, EGJ-DI increased by an average of 4.5 mm2/mmHg (95% CI (3.5, 5.5) (P<0.001). Within-subject Δ EGJ-DI was highly predictive of immediate clinical response with AUROC of 0.89 (95% CI [0.80, 0.98], P<0.001). An increment in EGJ-DI of 1.8 mm2/mmHg after a single PD predicts an immediate response with an accuracy of 87%.\nCONCLUSIONS: FLIP-measured Δ EGJ-DI is a novel intra-procedural tool that accurately predicts immediate clinical response to PD in achalasia. This technique may potentially dictate an immediate mechanism to \"step-up\" dilator size within a single endoscopy session.Am J Gastroenterol advance online publication, 5 December 2017; doi:10.1038/ajg.2017.411.", "publicationTitle": "The American Journal of Gastroenterology", "publisher": "", "place": "", "date": "Dec 05, 2017", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am. J. Gastroenterol.", "DOI": "10.1038/ajg.2017.411", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1572-0241", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 29206815", "tags": [], "collections": [ "P8Z4N4V9" ], "relations": {}, "dateAdded": "2017-12-06T19:38:42Z", "dateModified": "2017-12-06T19:38:42Z" } }, { "key": "VNK2DQ2X", "version": 1566, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/VNK2DQ2X", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/VNK2DQ2X", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/5EED3HZA", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "VNK2DQ2X", "version": 1566, "parentItem": "5EED3HZA", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-25T00:28:12Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25604060", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-25T00:28:12Z", "dateModified": "2016-03-25T00:28:12Z" } }, { "key": "3TP6JSGT", "version": 1565, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/3TP6JSGT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/3TP6JSGT", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/2A4V8DTS", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "3TP6JSGT", "version": 1565, "parentItem": "2A4V8DTS", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-25T00:23:22Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/26123332", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-25T00:23:22Z", "dateModified": "2016-03-25T00:23:22Z" } }, { "key": "2A4V8DTS", "version": 1565, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/2A4V8DTS", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/2A4V8DTS", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Jones et al.", "parsedDate": "2016-03", "numChildren": 1 }, "data": { "key": "2A4V8DTS", "version": 1565, "itemType": "journalArticle", "title": "Gastroesophageal reflux symptoms do not correlate with objective pH testing after peroral endoscopic myotomy", "creators": [ { "creatorType": "author", "firstName": "Edward L.", "lastName": "Jones" }, { "creatorType": "author", "firstName": "Michael P.", "lastName": "Meara" }, { "creatorType": "author", "firstName": "Jennifer S.", "lastName": "Schwartz" }, { "creatorType": "author", "firstName": "Jeffrey W.", "lastName": "Hazey" }, { "creatorType": "author", "firstName": "Kyle A.", "lastName": "Perry" } ], "abstractNote": "INTRODUCTION: Peroral endoscopic myotomy (POEM) is an emerging treatment for esophageal achalasia. Postoperative reflux has been found in a significant number of patients, but it is unknown whether subjective reports of reflux correlate with objective pH testing. The purpose of this study was to compare the objective rate of reflux with standardized reflux symptom scales after POEM. Our hypothesis was that subjective symptoms would not correlate with objective measurement of reflux.\nMETHODS AND PROCEDURES: Data on all patients undergoing POEM were collected prospectively between August 2012 and June 2014 and included demographics, objective testing (48-h pH probe, manometry, endoscopy), as well as gastroesophageal reflux disease health-related quality of life (GERD-HRQL), GERD symptom scale (GERSS), and antacid use.\nRESULTS: Forty-three patients underwent POEM during the study period. The mean age was 53.5 ± 17.4 years with a BMI of 29.6 ± 8.4 kg/m(2), and 27 (63%) were male. Forty-two patients (98%) completed at least 6 months of follow-up, and 26 (60%) underwent repeat pH measurement. Dysphagia scores improved from 4 (0-5) at baseline to 0 (0-3) (p < 0.001). On follow-up pH testing, 11 (42%) were normal and 15 (58%) had elevated DeMeester scores. Postoperative GERSS or GERD-HRQL scores did not correlate with DeMeester scores on Spearman's rank-order tests (r = 0.02, p = 0.93 and r = 0.04, p = 0.50, respectively). Postoperative PPI use was not significantly associated with normal or abnormal pH testing: 5 of 7 (71%) patients who were taking PPIs postoperatively had abnormal DeMeester scores compared to 9 of 18 (50%) of patients who were not taking PPIs (p = 0.332).\nCONCLUSIONS: Peroral endoscopic myotomy provides excellent dysphagia relief for patients with achalasia, but is associated with a high rate of reflux on pH testing postoperatively. Subjective symptoms are not a reliable indicator of postoperative reflux. Routine pH testing should be considered in all patients following POEM.", "publicationTitle": "Surgical Endoscopy", "publisher": "", "place": "", "date": "Mar 2016", "volume": "30", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "947-952", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Surg Endosc", "DOI": "10.1007/s00464-015-4321-8", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1432-2218", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 26123332", "tags": [ { "tag": "POEM", "type": 1 }, { "tag": "Proton pump inhibitor", "type": 1 }, { "tag": "Reflux", "type": 1 }, { "tag": "Subjective", "type": 1 }, { "tag": "achalasia", "type": 1 }, { "tag": "pH", "type": 1 } ], "collections": [ "5X3JQQ68" ], "relations": {}, "dateAdded": "2016-03-25T00:23:22Z", "dateModified": "2016-03-25T00:23:22Z" } }, { "key": "94V9ZAEQ", "version": 1564, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/94V9ZAEQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/94V9ZAEQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Fumagalli et al.", "parsedDate": "2016-03", "numChildren": 1 }, "data": { "key": "94V9ZAEQ", "version": 1564, "itemType": "journalArticle", "title": "Repeated Surgical or Endoscopic Myotomy for Recurrent Dysphagia in Patients After Previous Myotomy for Achalasia", "creators": [ { "creatorType": "author", "firstName": "Uberto", "lastName": "Fumagalli" }, { "creatorType": "author", "firstName": "Riccardo", "lastName": "Rosati" }, { "creatorType": "author", "firstName": "Stefano", "lastName": "De Pascale" }, { "creatorType": "author", "firstName": "Matteo", "lastName": "Porta" }, { "creatorType": "author", "firstName": "Elisa", "lastName": "Carlani" }, { "creatorType": "author", "firstName": "Alessandra", "lastName": "Pestalozza" }, { "creatorType": "author", "firstName": "Alessandro", "lastName": "Repici" } ], "abstractNote": "AIM: Surgical myotomy of the lower esophageal sphincter has a 5-year success rate of approximately 91 %. Peroral endoscopic myotomy can provide similar results for controlling dysphagia. Some patients experience either persistent or recurrent dysphagia after myotomy. We present here a retrospective analysis of our experience with redo myotomy for recurrent dysphagia in patients with achalasia.\nMETHODS: From March 1996 to February 2015, 234 myotomies for primary or recurrent achalasia were performed in our center. Fifteen patients (6.4 %) had had a previous myotomy and were undergoing surgical redo myotomy (n = 9) or endoscopic redo myotomy (n = 6) for recurrent symptoms.\nRESULTS: Patients presented at a median of 10.4 months after previous myotomy. Median preoperative Eckardt score was 6. Among the nine patients undergoing surgical myotomy, three esophageal perforations occurred intraoperatively (all repaired immediately). Surgery lasted 111 and 62 min on average (median) in the surgical and peroral endoscopic myotomy (POEM) groups, respectively. No postoperative complications occurred in either group. Median postoperative stay was 3 and 2.5 days in the surgical and POEM groups, respectively. In the surgical group, Eckardt score was <3 for seven out of nine patients after a mean follow-up of 19 months; it was <3 for all six patients in the POEM group after a mean follow-up of 5 months.\nCONCLUSIONS: A redo myotomy should be considered in patients who underwent myotomy for achalasia and presenting with recurrent dysphagia. Preliminary results using POEM indicate that the technique can be safely used in patients who have undergone previous surgical myotomy.", "publicationTitle": "Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract", "publisher": "", "place": "", "date": "Mar 2016", "volume": "20", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "494-499", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J. Gastrointest. Surg.", "DOI": "10.1007/s11605-015-3031-9", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1873-4626", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 26589525", "tags": [ { "tag": "Laparoscopic myotomy", "type": 1 }, { "tag": "Peroral endoscopic myotomy", "type": 1 }, { "tag": "achalasia", "type": 1 }, { "tag": "dysphagia", "type": 1 } ], "collections": [ "H4KSJU5H" ], "relations": {}, "dateAdded": "2016-03-25T00:05:26Z", "dateModified": "2016-03-25T00:05:26Z" } }, { "key": "W3FK2XZD", "version": 1564, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/W3FK2XZD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/W3FK2XZD", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/94V9ZAEQ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "W3FK2XZD", "version": 1564, "parentItem": "94V9ZAEQ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-25T00:05:26Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/26589525", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-25T00:05:26Z", "dateModified": "2016-03-25T00:05:26Z" } }, { "key": "2DVMP2WN", "version": 1563, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/2DVMP2WN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/2DVMP2WN", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/5DDARD2R", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "2DVMP2WN", "version": 1563, "parentItem": "5DDARD2R", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-24T23:58:57Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25987787", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-24T23:58:57Z", "dateModified": "2016-03-24T23:58:57Z" } }, { "key": "5DDARD2R", "version": 1563, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/5DDARD2R", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/5DDARD2R", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Lu et al.", "parsedDate": "2015-05-14", "numChildren": 1 }, "data": { "key": "5DDARD2R", "version": 1563, "itemType": "journalArticle", "title": "Effect of peroral esophageal myotomy for achalasia treatment: A Chinese study", "creators": [ { "creatorType": "author", "firstName": "Bin", "lastName": "Lu" }, { "creatorType": "author", "firstName": "Meng", "lastName": "Li" }, { "creatorType": "author", "firstName": "Yue", "lastName": "Hu" }, { "creatorType": "author", "firstName": "Yi", "lastName": "Xu" }, { "creatorType": "author", "firstName": "Shuo", "lastName": "Zhang" }, { "creatorType": "author", "firstName": "Li-Jun", "lastName": "Cai" } ], "abstractNote": "AIM: To assess the safety and feasibility of peroral esophageal myotomy (POEM) in patients with achalasia.\nMETHODS: From January 2012 to March 2014, 50 patients (28 men, 22 women; mean age: 42.8 years, range: 14-70 years) underwent POEM. Pre- and postoperative symptoms were quantified using the Eckardt scoring system. Barium swallow and esophagogastroscopy were performed before and after POEM, respectively. Esophageal motility was evaluated in all patients, both preoperatively and one month after POEM treatment, using a high-resolution manometry system. Manometry data, Eckardt scores, lower esophageal sphincter pressure and barium swallow results were used to evaluate the effect of the procedure.\nRESULTS: POEM was successfully completed for all patients. The mean procedure time was 55.4 ± 17.3 min and the mean total length of myotomy of the circular esophagus was 10.5 ± 2.6 cm. No specific complications occurred, with the exception of two patients that developed asymptomatic pneumomediastinum and subcutaneous emphysema. Clinical improvement in symptoms was achieved in all patients. Approximately 77.5% of patients experienced weight gain 6 mo after POEM, with an average of 4.78 kg (range: 2-15 kg). The lower esophageal sphincter resting pressure, four second integrated relaxation pressure and Eckardt scores were all significantly reduced after POEM (Ps < 0.05). A small segment of proximal esophageal peristalsis appeared postoperatively in two patients, but without normal esophageal peristalsis. The average diameter of the esophageal lumen decreased significantly from 4.39 to 3.09 cm (P < 0.01).\nCONCLUSION: POEM can relieve achalasia symptoms, improve gastroesophageal junction relaxation and restore esophageal body motility function, but not normal esophageal peristalsis.", "publicationTitle": "World Journal of Gastroenterology", "publisher": "", "place": "", "date": "May 14, 2015", "volume": "21", "issue": "18", "section": "", "partNumber": "", "partTitle": "", "pages": "5622-5629", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "World J. Gastroenterol.", "DOI": "10.3748/wjg.v21.i18.5622", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "2219-2840", "archive": "", "archiveLocation": "", "shortTitle": "Effect of peroral esophageal myotomy for achalasia treatment", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 25987787\nPMCID: PMC4427686", "tags": [ { "tag": "High-resolution manometry", "type": 1 }, { "tag": "Peroral endoscopic myotomy", "type": 1 }, { "tag": "achalasia", "type": 1 } ], "collections": [ "ICD7VHEU" ], "relations": {}, "dateAdded": "2016-03-24T23:58:57Z", "dateModified": "2016-03-24T23:58:57Z" } }, { "key": "RX666UIE", "version": 1562, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/RX666UIE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/RX666UIE", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/SV8M39TH", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "RX666UIE", "version": 1562, "parentItem": "SV8M39TH", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-24T23:56:45Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/26498923", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-24T23:56:45Z", "dateModified": "2016-03-24T23:56:45Z" } }, { "key": "SV8M39TH", "version": 1562, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/SV8M39TH", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/SV8M39TH", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Hu et al.", "parsedDate": "2015-10-25", "numChildren": 1 }, "data": { "key": "SV8M39TH", "version": 1562, "itemType": "journalArticle", "title": "Esophageal motility after peroral endoscopic myotomy for achalasia", "creators": [ { "creatorType": "author", "firstName": "Yue", "lastName": "Hu" }, { "creatorType": "author", "firstName": "Meng", "lastName": "Li" }, { "creatorType": "author", "firstName": "Bin", "lastName": "Lu" }, { "creatorType": "author", "firstName": "Lina", "lastName": "Meng" }, { "creatorType": "author", "firstName": "Yihong", "lastName": "Fan" }, { "creatorType": "author", "firstName": "Haibiao", "lastName": "Bao" } ], "abstractNote": "BACKGROUND: Peroral endoscopic myotomy (POEM) has been introduced as a novel endoscopic treatment for achalasia. The aim of this work is to assess the changes in esophageal motility caused by POEM in patients with achalasia.\nMETHODS: Forty-one patients with achalasia underwent POEM from September 2012 to November 2014. Esophageal motility of all patients was evaluated preoperatively and 1 month after POEM utilizing high-resolution manometry, which was performed with ten water swallows, ten steamed bread swallows, and multiple rapid swallows (MRS).\nRESULTS: In single swallows, including liquid swallows and bread swallows, all the parameters of lower esophagus sphincter resting pressure (LESP), 4-s integrated relaxation pressure (4sIRP), and intra-bolus pressure (IBP) were decreased between pre- and post-POEM patients (all p < 0.05). Postoperatively, the trend of distal contractile integral (DCI) and distal esophageal peristaltic amplitude declined in subtype II and subtype III (subtype II: p < 0.05; subtype III: p > 0.05), but increased in subtype I (subtype I: p > 0.05). In liquid swallows, the Eckardt score of subtype II patients decreased with DCI, and distal esophageal peristaltic amplitude after POEM was significantly lower compared with those showing increased values of those two parameters (p < 0.05). In MRS, the rate of LES relaxation increased from 66.67 to 95.24 %, but without normal response in all achalasia patients.\nCONCLUSIONS: POEM reduces LES pressure in achalasia, and partly restores esophageal motility. POEM displayed varying effect on esophageal motility in patients with different patterns of swallowing. In addition, the changes in parameters associated with esophageal peristalsis correlated with decreases in Eckardt score.", "publicationTitle": "Journal of Gastroenterology", "publisher": "", "place": "", "date": "Oct 25, 2015", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J. Gastroenterol.", "DOI": "10.1007/s00535-015-1123-7", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1435-5922", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "ENG", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 26498923", "tags": [ { "tag": "High-resolution manometry", "type": 1 }, { "tag": "Peroral endoscopic myotomy (POEM)", "type": 1 }, { "tag": "achalasia", "type": 1 } ], "collections": [ "ICD7VHEU" ], "relations": {}, "dateAdded": "2016-03-24T23:56:45Z", "dateModified": "2016-03-24T23:56:45Z" } }, { "key": "F45GDNJW", "version": 1561, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/F45GDNJW", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/F45GDNJW", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/GHR6RUF2", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "F45GDNJW", "version": 1561, "parentItem": "GHR6RUF2", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-24T23:44:47Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/26674979", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-24T23:44:47Z", "dateModified": "2016-03-24T23:44:47Z" } }, { "key": "GHR6RUF2", "version": 1561, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/GHR6RUF2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/GHR6RUF2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Park et al.", "parsedDate": "2016-01", "numChildren": 1 }, "data": { "key": "GHR6RUF2", "version": 1561, "itemType": "journalArticle", "title": "Changes in pressure waves after endoscopic intervention in patients with achalasia: A focus on peristaltic recovery of the esophageal body", "creators": [ { "creatorType": "author", "firstName": "Se Kyung", "lastName": "Park" }, { "creatorType": "author", "firstName": "Su Jin", "lastName": "Hong" }, { "creatorType": "author", "firstName": "Jae Pil", "lastName": "Han" }, { "creatorType": "author", "firstName": "Hyeon Jeong", "lastName": "Goong" }, { "creatorType": "author", "firstName": "Hyun Soo", "lastName": "Kim" }, { "creatorType": "author", "firstName": "Yu Sik", "lastName": "Myung" }, { "creatorType": "author", "firstName": "Shin Hee", "lastName": "Kim" }, { "creatorType": "author", "firstName": "Hee Jae", "lastName": "Jung" }, { "creatorType": "author", "firstName": "Tae Hee", "lastName": "Lee" }, { "creatorType": "author", "firstName": "Joon Seong", "lastName": "Lee" }, { "creatorType": "author", "firstName": "Moon Sung", "lastName": "Lee" } ], "abstractNote": "BACKGROUND/AIMS: We conducted the present study to investigate the recovery of peristalsis of the esophageal body and evaluate the pressure changes observed on manometry before and after endoscopic intervention.\nMATERIALS AND METHODS: Forty-five patients were diagnosed with achalasia, and 36 received endoscopic or surgical treatment. We collected the data of 24 patients who underwent manometry before and after treatment (pneumatic balloon dilatation, n=7; botulinum toxin injection, n=10; peroral endoscopic myotomy, n=7).\nRESULTS: The lower esophageal sphincter (LES) resting pressure and nadir LES relaxation pressure decreased regardless of the achalasia subtype or type of endoscopic intervention following treatment (p<0.05). Among patients with a nadir LES relaxation pressure of <4 mmHg, 42.9% (6/14) exhibited partial esophageal peristaltic wave recovery. However, no patients with a nadir LES relaxation pressure of >4 mmHg exhibited peristaltic wave recovery (p=0.024). Of the six patients with peristaltic wave recovery, two had type I achalasia (15.4%), three had type II (33.3%), and one had type III (100.0%). The Eckardt score, symptom duration, and type of intervention were not associated with the recovery of peristaltic waves.\nCONCLUSION: Our results suggest that normalization of the nadir LES relaxation pressure can be a predictive factor for the recovery of esophageal peristalsis.", "publicationTitle": "The Turkish Journal of Gastroenterology: The Official Journal of Turkish Society of Gastroenterology", "publisher": "", "place": "", "date": "Jan 2016", "volume": "27", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "4-9", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Turk J Gastroenterol", "DOI": "10.5152/tjg.2015.150271", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "2148-5607", "archive": "", "archiveLocation": "", "shortTitle": "Changes in pressure waves after endoscopic intervention in patients with achalasia", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 26674979", "tags": [], "collections": [ "ICD7VHEU" ], "relations": {}, "dateAdded": "2016-03-24T23:44:47Z", "dateModified": "2016-03-24T23:44:47Z" } }, { "key": "WQH9EXXR", "version": 1560, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/WQH9EXXR", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/WQH9EXXR", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/9AA25T7X", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "WQH9EXXR", "version": 1560, "parentItem": "9AA25T7X", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-03-24T23:02:51Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/26882171", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-03-24T23:02:51Z", "dateModified": "2016-03-24T23:02:51Z" } }, { "key": "9AA25T7X", "version": 1560, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/9AA25T7X", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/9AA25T7X", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Becker et al.", "parsedDate": "2016-02-12", "numChildren": 1 }, "data": { "key": "9AA25T7X", "version": 1560, "itemType": "journalArticle", "title": "Comprehensive epidemiological and genotype-phenotype analyses in a large European sample with idiopathic achalasia", "creators": [ { "creatorType": "author", "firstName": "Jessica", "lastName": "Becker" }, { "creatorType": "author", "firstName": "Stefan", "lastName": "Niebisch" }, { "creatorType": "author", "firstName": "Arcangelo", "lastName": "Ricchiuto" }, { "creatorType": "author", "firstName": "Eva J.", "lastName": "Schaich" }, { "creatorType": "author", "firstName": "Gavin", "lastName": "Lehmann" }, { "creatorType": "author", "firstName": "Tobias", "lastName": "Waltgenbach" }, { "creatorType": "author", "firstName": "Annette", "lastName": "Schafft" }, { "creatorType": "author", "firstName": "Timo", "lastName": "Hess" }, { "creatorType": "author", "firstName": "Frank", "lastName": "Lenze" }, { "creatorType": "author", "firstName": "Marino", "lastName": "Venerito" }, { "creatorType": "author", "firstName": "Robert", "lastName": "Hüneburg" }, { "creatorType": "author", "firstName": "Philipp", "lastName": "Lingohr" }, { "creatorType": "author", "firstName": "Hanno", "lastName": "Matthaei" }, { "creatorType": "author", "firstName": "Stefan", "lastName": "Seewald" }, { "creatorType": "author", "firstName": "Uwe", "lastName": "Scheuermann" }, { "creatorType": "author", "firstName": "Nicole", "lastName": "Kreuser" }, { "creatorType": "author", "firstName": "Lothar", "lastName": "Veits" }, { "creatorType": "author", "firstName": "Mira M.", "lastName": "Wouters" }, { "creatorType": "author", "firstName": "Henning R.", "lastName": "Gockel" }, { "creatorType": "author", "firstName": "Hauke", "lastName": "Lang" }, { "creatorType": "author", "firstName": "Michael", "lastName": "Vieth" }, { "creatorType": "author", "firstName": "Michaela", "lastName": "Müller" }, { "creatorType": "author", "firstName": "Alexander J.", "lastName": "Eckardt" }, { "creatorType": "author", "firstName": "Burkhard H. A.", "lastName": "von Rahden" }, { "creatorType": "author", "firstName": "Michael", "lastName": "Knapp" }, { "creatorType": "author", "firstName": "Guy E.", "lastName": "Boeckxstaens" }, { "creatorType": "author", "firstName": "Rolf", "lastName": "Fimmers" }, { "creatorType": "author", "firstName": "Markus M.", "lastName": "Nöthen" }, { "creatorType": "author", "firstName": "Henning G.", "lastName": "Schulz" }, { "creatorType": "author", "firstName": "Ines", "lastName": "Gockel" }, { "creatorType": "author", "firstName": "Johannes", "lastName": "Schumacher" } ], "abstractNote": "BACKGROUND AND AIM: Although an eight-residue insertion in HLA-DQβ1 has been recently identified as a genetic risk factor for idiopathic achalasia, other risk factors are still unknown. In the present study, we carried out an epidemiological survey and a genotype-phenotype (G×P) analysis to gain further insights into the etiology of achalasia.\nMETHODS: We obtained medical data from 696 achalasia patients and 410 controls, as well as their first-degree relatives (2543 of patients and 1497 of controls). For the G×P analysis, we stratified the patients into HLA-DQβ1 insertion carriers and noncarriers.\nRESULTS: Our data show that patients are more often affected by viral infections before achalasia onset (P<0.0001, most significantly for varicella zoster virus infections). In addition, allergic (P=0.0005) and autoimmune disorders (P=0.0007, most significantly for psoriasis and Sjögren's syndrome) represent comorbid disease conditions. First-degree relatives of patients also show higher prevalence rates of allergic disorders (P=0.0007) and psoriasis (P=0.016) compared with control relatives. Moreover, the G×P analysis reveals that achalasia is triggered by pregnancies in female HLA-DQβ1 insertion carriers (P=0.031).\nCONCLUSION: Our data point to a role of viral infections in the development of achalasia. In addition, they provide evidence for a relationship between achalasia and allergic, as well as autoimmune, disorders. Furthermore, pregnancy seems to be a disease-triggering factor in female HLA-DQβ1 insertion carriers, which points to hormonal and/or immunosuppressive factors influencing disease development.", "publicationTitle": "European Journal of Gastroenterology & Hepatology", "publisher": "", "place": "", "date": "Feb 12, 2016", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Eur J Gastroenterol Hepatol", "DOI": "10.1097/MEG.0000000000000602", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1473-5687", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "ENG", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 26882171", "tags": [], "collections": [ "5CTME5EG" ], "relations": {}, "dateAdded": "2016-03-24T23:02:51Z", "dateModified": "2016-03-24T23:02:51Z" } }, { "key": "JVHSRJTD", "version": 1559, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/JVHSRJTD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/JVHSRJTD", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/54KD5ESB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "JVHSRJTD", "version": 1559, "parentItem": "54KD5ESB", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-22T07:00:18Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22947106", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-01-22T07:00:18Z", "dateModified": "2016-01-22T07:00:18Z" } }, { "key": "54KD5ESB", "version": 1559, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/54KD5ESB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/54KD5ESB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Kallel-Sellami et al.", "parsedDate": "2013-12", "numChildren": 1 }, "data": { "key": "54KD5ESB", "version": 1559, "itemType": "journalArticle", "title": "Circulating antimyenteric autoantibodies in Tunisian patients with idiopathic achalasia", "creators": [ { "creatorType": "author", "firstName": "M.", "lastName": "Kallel-Sellami" }, { "creatorType": "author", "firstName": "S.", "lastName": "Karoui" }, { "creatorType": "author", "firstName": "H.", "lastName": "Romdhane" }, { "creatorType": "author", "firstName": "L.", "lastName": "Laadhar" }, { "creatorType": "author", "firstName": "M.", "lastName": "Serghini" }, { "creatorType": "author", "firstName": "J.", "lastName": "Boubaker" }, { "creatorType": "author", "firstName": "H.", "lastName": "Lahmar" }, { "creatorType": "author", "firstName": "A.", "lastName": "Filali" }, { "creatorType": "author", "firstName": "S.", "lastName": "Makni" } ], "abstractNote": "The physiopathology of idiopathic achalasia is still unknown. The description of circulating antimyenteric autoantibodies (CAA), directed against enteric neurons in sera of patients, suggests an autoimmune process. Recent data showed controversies according to the existence and the significance of CAA. The aims of this study were to investigate whether CAA are detected in Tunisian patients with idiopathic achalasia and to look for associated clinical or manometrical factors with CAA positivity. Twenty-seven patients with idiopathic achalasia and 57 healthy controls were prospectively studied. CAA were assessed by indirect immunofluorescence on intestinal monkey tissue sections. Western blot on primate cerebellum protein extract and dot technique with highly purified recombinant neuronal antigens (Hu, Ri, and Yo) were further used to analyze target antigens of CAA. CAA were significantly increased in achalasia patients compared with controls when considering nuclear or cytoplasmic fluorescence patterns. (33% vs. 12%, P = 0.03 and 48% vs. 23%, P = 0.001 respectively). By immunoblot analysis, CAA did not target neuronal antigens, however 52/53 and 49 kDa bands were consistently detected. CAA positivity was not correlated to specific clinical features. The results are along with previous studies demonstrating high CAA prevalence in achalasia patients. When reviewing technical protocols and interpretation criteria, several discrepancies which could explain controversies between studies were noted.", "publicationTitle": "Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E", "publisher": "", "place": "", "date": "2013 Nov-Dec", "volume": "26", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "782-787", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Dis. Esophagus", "DOI": "10.1111/j.1442-2050.2012.01398.x", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1442-2050", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22947106", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Autoantibodies", "type": 1 }, { "tag": "Case-Control Studies", "type": 1 }, { "tag": "Esophageal Achalasia", "type": 1 }, { "tag": "Esophageal Sphincter, Lower", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Fluorescent Antibody Technique, Indirect", "type": 1 }, { "tag": "Ganglia, Autonomic", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Manometry", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Myenteric Plexus", "type": 1 }, { "tag": "Young Adult", "type": 1 }, { "tag": "circulating antimyenteric autoantibody", "type": 1 }, { "tag": "human leukocyte antigen", "type": 1 }, { "tag": "idiopathic achalasia", "type": 1 }, { "tag": "immunoblot", "type": 1 }, { "tag": "indirect immunofluorescence", "type": 1 } ], "collections": [ "XX9SCJ8R" ], "relations": {}, "dateAdded": "2016-01-22T07:00:18Z", "dateModified": "2016-01-22T07:00:18Z" } }, { "key": "W9GHQVCH", "version": 1558, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/W9GHQVCH", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/W9GHQVCH", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/13068/items/RCPAFV3D", "type": "application/json" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } } }, "data": { "key": "W9GHQVCH", "version": 1558, "parentItem": "RCPAFV3D", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-22T06:20:07Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/26542087", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-01-22T06:20:07Z", "dateModified": "2016-01-22T06:20:07Z" } }, { "key": "RCPAFV3D", "version": 1558, "library": { "type": "group", "id": 13068, "name": "Achalasia Atheneum", "links": { "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/13068/items/RCPAFV3D", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/achalasia_atheneum/items/RCPAFV3D", "type": "text/html" } }, "meta": { "createdByUser": { "id": 155876, "username": "notan", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/notan", "type": "text/html" } } }, "creatorSummary": "Sodikoff et al.", "parsedDate": "2016-01", "numChildren": 1 }, "data": { "key": "RCPAFV3D", "version": 1558, "itemType": "journalArticle", "title": "Histopathologic patterns among achalasia subtypes", "creators": [ { "creatorType": "author", "firstName": "J. B.", "lastName": "Sodikoff" }, { "creatorType": "author", "firstName": "A. A.", "lastName": "Lo" }, { "creatorType": "author", "firstName": "B. B.", "lastName": "Shetuni" }, { "creatorType": "author", "firstName": "P. J.", "lastName": "Kahrilas" }, { "creatorType": "author", "firstName": "G.-Y.", "lastName": "Yang" }, { "creatorType": "author", "firstName": "J. E.", "lastName": "Pandolfino" } ], "abstractNote": "BACKGROUND: Achalasia has three distinct manometric phenotypes. This study aimed to determine if there were corresponding histopathologic patterns.\nMETHODS: We retrospectively examined surgical muscularis propria biopsies obtained from 46 patients during laparoscopic esophagomyotomy. Pre-operative (conventional) manometry tracings were reviewed by two expert gastroenterologists who categorized patients into Chicago Classification subtypes. Pathology specimens were graded on degree of neuronal loss, inflammation, fibrosis, and muscle changes.\nKEY RESULTS: Manometry studies were categorized as follows: type I (n = 20), type II (n = 20), type III (n = 3), and esophagogastric junction outflow obstruction (EGJOO) (n = 3). On histopathology, complete ganglion cell loss occurred in 74% of specimens, inflammation in 17%, fibrosis in 11%, and muscle atrophy in 2%. Comparing type I and type II specimens, there was a statistically significant greater proportion of type I specimens with aganglionosis (19/20 vs 13/20, p = 0.044) and a statistically significant greater degree of ganglion cell loss in type I specimens (Wilcoxon Rank-Sum, p = 0.016). CD3(+) /CD8(+) cytotoxic T cells represented the predominant inflammatory infiltrate on immunohistochemistry. Three patients had completely normal appearing tissue (1 each in type II, type III, EGJOO).\nCONCLUSIONS & INFERENCES: The greater degree, but similar pattern, of ganglion cell loss observed in type I compared to type II achalasia specimens suggests that type I achalasia represents a progression from type II achalasia. The spectrum of histopathologic findings - from complete neuronal loss to lymphocytic inflammation to apparently normal histopathology - emphasizes that 'achalasia' represents a pathogenically heterogeneous patient group with the commonality being EGJ outflow obstruction.", "publicationTitle": "Neurogastroenterology and Motility: The Official Journal of the European Gastrointestinal Motility Society", "publisher": "", "place": "", "date": "Jan 2016", "volume": "28", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "139-145", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Neurogastroenterol. Motil.", "DOI": "10.1111/nmo.12711", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1365-2982", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 26542087\nPMCID: PMC4688144", "tags": [ { "tag": "Esophagus", "type": 1 }, { "tag": "Immunohistochemistry", "type": 1 }, { "tag": "achalasia", "type": 1 }, { "tag": "histopathology", "type": 1 }, { "tag": "motility", "type": 1 } ], "collections": [ "V4JTUM3M" ], "relations": {}, "dateAdded": "2016-01-22T06:20:07Z", "dateModified": "2016-01-22T06:20:07Z" } } ]